Abstract 13343: Cognitive Impairment in Older Adults With Peripheral Arterial Disease

Abstract

Introduction: Peripheral arterial disease (PAD) is common among older adults and shares a pathophysiologic mechanism with vascular dementia, yet there remains a paucity of data about the prevalence of cognitive impairment (CI) in this population. The aim of this study was to estimate CI prevalence in a nationally representative sample of adults with PAD and identify independent risk factors for CI. Hypothesis: We hypothesized CI would be common and that risk factors would include advancing age. Methods: The U.S. Health and Retirement Study with Medicare Linkage and CI assessment was utilized for years 2000-2016. PAD was identified using ICD-9/10 and CPT codes. CI was defined using the Langa-Weir classification based on CI assessment within 2.5 years prior to first documented PAD diagnosis in the Medicare. Bivariate analysis for association with CI was performed appropriate to the data followed by multivariable logistic regression for the primary endpoint of CI. Results: Overall, 4,383 PAD individuals aged 65 and over at time of PAD diagnosis were included. Overall, 39% had CI. CI was associated with increasing age (p<0.01) female gender (42% females vs. 35% males, p<0.01) Race (60% Black, 66% Hispanics, 31% white, p<0.01) and Charlson score>2 (p<0.01). Geriatric syndromes were common with mean 1.7 (SD 1.5, p<0.01) and were associated with CI (2.7 in CI vs. 1.0 in no CI, p<0.01). On multivariable analysis risk factors included age, education, Race, vision impairment, depression, falls within the past year, and any dependency in activities of daily living (Table 1). Conclusions: Cognitive impairment is common in adults living with PAD and is associated with age, race/ethnicity, education, depression, geriatric syndromes and functional status, similar to those without PAD. Given CI’s prevalence in individuals with PAD, future study is imperative to understand how CI impacts PAD related health. These findings can be used to risk stratify patients for CI screening.